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Current Clinical Research Projects at BIDMC

Why are reported non-union rates after locked plate fixation of distal femur fractures so variable?: A multicenter retrospective study of 284 fractures

A study designed to determine patient and injury factors that increase the risk of nonunion when locked plating is used in the fixation of distal femoral fractures. Distal femur nonunion rates between the different Harvard-affiliated trauma services are also compared. We hypothesize that the institutional difference in nonunion rates may be secondary to the surgeon and institutional approach to nonunion care, to how nonunion is defined, and what factors motivate intervention.

Results and outcomes after staged treatment of high energy pilon fracture

An ongoing study designed to evaluate the results and outcomes of pilon fractures managed with a staged protocol of external fixation followed by locked plating at the BIDMC. We hypothesize that staged treatment with locked plating does not necessarily improve on reported outcomes when standard plates were used and nonunion failures may be further delayed.

Validating the Lauge-Hansen ankle fracture classification system for in-vivo ankle fractures using YouTube videos of live injuries

A study designed to examine the true live mechanisms of ankle fractures as seen in selected YouTube video clips to then relate them to the actual x-rays associated with each specific injury. The objective is to either validate or disprove the Lauge-Hansen classification system for ankle fractures initially developed using static forces on cadavers.

A case study series to assess of the utility of routine radiographs following uncomplicated hemiarthroplasty of the hip

A study designed to investigate the cost-effectiveness of performing routine screening x-rays for patients with hemiarthroplasties of the hip. We will review overall incidence of abnormal radiographic findings to determine whether they altered patient care in terms of outcome and length of stay. Resident: Bryce Wolf

Assessment of technical and patient parameters determining intra-operative radiation exposure in hip fractures

A study designed to assess factors influencing the use of intra-operative radiation when treating various hip fractures. Resident: Mike Baratz.

Outcomes of surgical management of traumatic femoral fractures managed with cephalomedullary fixation and plating

An inter-institutional study designed to assess outcomes in traumatic proximal femur fractures treated with IM nailing vs. sliding screw fixation. The aims of the study are to: 1) Compare outcomes for lateral vs. supine surgical positioning for proximal femur fractures, 2) Compare outcomes for short vs. long cephalomedullary nailing for proximal femur fractures, 3) Compare outcomes for cephalomedullary nailing vs. traditional sliding screw plating of proximal femur fractures, and 4) Assess if technical parameters used to assess the radiographic quality of reduction and fixation in sliding screw plating are also applicable to cephalomedullary nailing. Resident: Conor Kleweno; HMS Student JT Redshaw.

Outcomes of lateral compression type 1 pelvic fractures in octogenarians

A study to assess the outcomes of LC-1 pelvic fractures in octogenarian patients managed with conservative care. We hypothesize that outcomes for conservatively treated LC-1 fractures are not as benign as presently believed and that one year mortality rates may be comparable to those rates seen in hip fractures. Resident: Beverlie Ting

Outcome of operative vs. non-operative acetabular fractures in elderly patients

A study comparing pain control, mortality and return to previous living conditions for geriatric patients with unstable acetabular fractures treated: a) non operatively, b) with standard ORIF, and c) with percutaneous stabilization. Resident: Ellen Fitzpatrick

Expected severity of postoperative anemia following hip fracture fixation in the elderly

A study aimed to better characterize the expected course for geriatric patients following hip fracture and hip fracture fixation in terms of blood loss and resultant drop in hemoglobin/hematocrit, with particular attention paid to patient and injury characteristics, anticoagulation status, and type of surgery performed. The goal is to create a predictive model for perioperative blood loss, to assist in the care of patients who may be at risk of requiring blood transfusion. Resident: Collin May

2011 Peer-Reviewed Publications

Abstracts and Presentations at Professional Meetings